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A Literature Review of Issues and Tasks by Period of Revision of Regulations Related to Convalescent Rehabilitation Wards in Japan: Focusing on Quality Evaluation

Minyoung LEE ; Boyoung JEON

Journal of Korean Physical Therapy.2022;34(1):26-37. doi:10.18857/jkpt.2022.34.1.26

Purpose: Japan established the convalescent rehabilitation wards, corresponding to Korea's rehabilitation medical institutions, in 2000 and developed it into the present system through continuous revisions. This study sought to analyze the issues and tasks faced by Japan segregated by the period of revision of convalescent rehabilitation ward-related medical fee regulations, through a literature review and further aimed to explore the direction of development of domestic rehabilitation medical institutions. Methods: Ten revisions of the medical fee regulations were classified into three stages based on quality evaluation: (1) the quantitative expansion stage (2000–2006); (2) quality evaluation introduction stage (2008–2014); and (3) quality evaluation maturity stage (2016– 2020). Results: The following issues and tasks emerged: (1) For the quantitative expansion stage; insufficient rehabilitation within the ward, insufficient after-hour rehabilitation, insufficient connection with acute-stage hospitals and maintenance facilities, and the low ratio of specialists. (2) For the quality evaluation introduction stage; disparity in the manpower between institutions, the necessity of a 365-day rehabilitation system, avoidance of critical patients, and the problem that an increase in the amount of rehabilitation did not lead to a qualitative improvement. 3) For the quality evaluation maturity stage; cream-skimming issues in selecting patients, inappropriate evaluation of rehabilitation effects, and the necessity of follow-up measures after discharge. Conclusion It is worth referring to the established regulations in Japan, and concurrently it is necessary to strengthen the evaluation of the structures, processes, and results when operating and evaluating rehabilitation medical institutions in Korea taking into account the side effects that could be identified in Japan.

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The Effects of the FIFA 11+ and Self-Myofascial Release Complex Training on Injury, Flexibility and Muscle Stiffness of High School Football Players

Young-In CHOI ; Houng-Sik CHOI ; Tack-Hoon KIM ; Kyu-Hwan CHOI ; Gyoung-Mo KIM ; Jung-Suk ROH

Journal of Korean Physical Therapy.2022;34(1):38-44. doi:10.18857/jkpt.2022.34.1.38

Purpose: The purpose of this study was to investigate the effects of complex training on injury, flexibility, and muscle stiffness in high school male football players. Methods: A total of 60 football players were included in the study and were divided into three groups viz. the complex training group (CTG), 11+ training group (11 + TG), and traditional training group (TTG). Injuries were recorded based on the prospective investigation method after starting the study, and the flexibility and muscle stiffness of the subjects were evaluated. Results: The research results showed that the injury rate per match was significantly lower in the CTG and 11 + TG than the TTG. In the CTG, the flexibility of the hamstrings significantly increased and the stiffness of the rectus femoris (RF), biceps femoris (BF), and tensor fascia latae (TFL) muscles significantly decreased (p < 0.05). In the 11 + TG, the stiffness of the RF significantly decreased (p < 0.05). In the TTG, the flexibility of the hamstrings significantly increased (p < 0.05). Hamstring flexibility showed a significantly higher increase in the CTG and TTG compared to the 11 + TG (p < 0.05). Also, the stiffness of the RF and TFL muscles showed a significantly higher decrease in the CTG compared to the 11 + TG and TTG (p < 0.05). The stiffness of the BF muscles too showed a more significant decrease in the CTG compared to the TTG (p < 0.05). Conclusion The complex training method of the Fédération International de Football Association (FIFA) 11+ and self-myofascial release (SMFR) as a warm-up program, prevent injuries, enhance flexibility, and lower muscle stiffness of football players in high school. Thus, it is necessary to ensure the widespread use of the complex training program by instructors and players under the supervision of the Korea Football Association (KFA), given its reliability in preventing injuries and improving the performance of football players.

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The Influence of COVID-19 on Physical Activity, Sleep Quality, and the Quality of Life in Adults by Age Group

Tae-Yeon KIM ; Sil-Ah CHOI

Journal of Korean Physical Therapy.2022;34(1):18-25. doi:10.18857/jkpt.2022.34.1.18

Purpose: The purpose of this study was to identify changes in physical activity, sleep quality, and quality of life (QOL) during COVID-19 in adults by age group. Methods: An online survey was conducted on a total of 160 participants who were divided into three groups by age; young adults, middle-aged adults, and old adults. The participants responded to the self-reported assessment of the impact of social distancing during COVID-19, International Physical Activity Questionnaire (IPAQ), Pittsburgh Sleep Quality Index (PSQI), and Short Form-36 Health Survey (SF-36). Descriptive statistics, analysis of variance, and Pearson’s correlation were used for data analysis. Results: There were significant differences between the three age groups in physical activity (p < 0.05) and PSQI (p < 0.01) and a post hoc analysis showed that the young adults’ group had significantly higher physical activity than the old adults’ group, while the old adults’ group had significantly lower scores of PSQI (better sleep quality) than the others. The young adults’ group showed a significant negative correlation between the stress from social distancing and QOL (r = -0.27, p < 0.05) and between PSQI and QOL (r = -0.48, p < 0.05). For the middle-aged adults’ group, there was a significant negative correlation between PSQI and QOL (r = -0.53, p < 0.05). The old adults’ group showed a significant negative correlation between the stress from social distancing and physical activity (r = -0.35, p < 0.05) and PSQI (r = -0.50, p < 0.05), while there was a significant positive correlation between physical activity and PSQI (r = 0.30, p < 0.05) and QOL (r = 0.30, p < 0.05). Conclusion The results of this study could be used as basic data for the promotion of physical and mental health in the post-COVID-19 era

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Differences in the Gait Pattern and Muscle Activity of the Lower Extremities during Forward and Backward Walking on Sand

Chae-Won KWON ; Seong Ho YUN ; Jung-Won KWON

Journal of Korean Physical Therapy.2022;34(1):45-50. doi:10.18857/jkpt.2022.34.1.45

Purpose: The purpose of this study was to compare the spatiotemporal and kinematic gait parameters and muscle activity of the lower extremities between forward walking on sand (FWS) and backward walking on sand (BWS) in normal adults. Methods: This study was conducted on 13 healthy adults. Subjects performed FWS and BWS and the spatiotemporal and kinematic gait parameters of stride time, stride length, velocity, cadence, step length, stance, swing, double support, and hip range of motion (ROM), knee ROM were measured by a wearable inertial measurement unit system. In addition, the muscle activity of the rectus femoris (RF), biceps femoris (BF), tibialis anterior (TA), and gastrocnemius (GA) was measured. Results: The stride length, stride velocity, cadence, and step length in the BWS were significantly lower than FWS (p < 0.05), and stride time was significantly greater (p < 0.05). However, there was no significant difference in the ratio of stance, swing, and double support between the two (p > 0.05). The kinematic gait parameters, including hip and knee joint range of motion in BWS, were significantly lower than FWS (p < 0.05). The muscle activity of the RF in BWS was significantly higher than FWS (p < 0.05), but the muscle activity of the BF, TA, GA did not show any significant differences between the two movements (p > 0.05). Conclusion A strategy to increase stability by changing the gait parameters is used in BWS, and this study confirmed that BWS was a safe and effective movement to increase RF muscle activity without straining the joints. Therefore, BWS can be recommended for effective activation of the RF.

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Comparison of Tibialis Anterior Muscle Thickness with 4 Different Toe and Ankle Postures: Ultrasonographic Study

Tae-Jin JANG ; Byeong-Hun HWANG ; In-Cheol JEON

Journal of Korean Physical Therapy.2022;34(1):12-17. doi:10.18857/jkpt.2022.34.1.12

Purpose: Ankle dorsiflexion is an essential element of normal functions, including walking, activities of daily living and sport activities.The tibialis anterior (TA) muscle functioned as a dorsiflexor and as a dynamic stabilizer of the ankle joint during walking and jumping.This study aimed to compare TA muscle thickness using ultrasonography according to the four different toe and ankle postures for the selective TA strengthening exercise. Methods: This study were recruited 26 (males: 15, females: 11) aged 20-30 years, with no injury ankle and calf in the medical history, had normal dorsiflexion and inversion range of motion (ROM). The thickness of the TA muscle was measured by ultrasonography in the four different toe and ankle postures: 1. Ankle dorsiflexion with all toe extension and ankle inversion (ITEDF); 2. Ankle dorsiflexion with all toe flexion and ankle inversion (ITFDF); 3. Ankle dorsiflexion with all toe extension and neutral position (NTEDF); 4. Ankle dorsiflexion with all toe flexion and neutral position (NTFDF). One-way repeated analysis of variance (ANOVA) and Bonferroni correction were used to confirm the significant difference among conditions. The level of statistical significance was set at α = 0.01. Results: TA muscle thickness with ITFDF was significantly greater than in any other ankle positions, including ITEDF, NTFDF, and NTEDF (p < 0.01). Conclusion Among the four toe and ankle postures, isometric contraction in ITFDF postures showed the greatest increase in thickness of TA rather than ITEDF, NTEDF, and NTFDF postures. Based on these results, ITFDF can be recommended in an efficient way to selectively strengthen TA muscle.

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Comparison of the Lower Trapezius Muscle Activity during Three Different Shoulder Flexion Exercises in Healthy Subjects

Byeong-Hun HWANG ; Tae-Jin JANG ; In-Cheol JEON

Journal of Korean Physical Therapy.2022;34(1):6-11. doi:10.18857/jkpt.2022.34.1.6

Purpose: This study investigated the muscle activity of the lower trapezius (LT) during three different shoulder flexion exercises. Methods: Twenty-three subjects between 20 and 25 years of age were enrolled. The subjects were asked to perform three different shoulder flexion exercises: 1) shoulder flexion in prone (SFP), 2) shoulder flexion in push-up with a swiss ball (SFPUS) and 3) shoulder flexion in a quadruped position with a swiss ball (SFQPS) in random order. The muscle activity of LT during each shoulder flexion exercise was measured by using surface electromyography. The muscle activity of LT was compared using one-way analysis of variance (ANOVA) and Bonferroni post hoc test among three different shoulder flexion exercises. The statistical significance level was set at α = 0.01. Results: The muscle activity of LT was significantly different among three different shoulder flexion exercises (SFP, SFPUS, and SFQPS).The LT muscle activity with SFQPS exercise was greater than SFP and SFPUS exercises (p < 0.01). There was no significant difference in LT muscle activity between SFP and SFPUS exercises (p > 0.01). Conclusion The LT muscle activity was greater during SFQPS than SFP and SFPUS. Therefore, SFQPS exercise can be recommended for selectively activation of LT muscle.

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The Effects of Prolonged Sitting in a Cross-legged Posture on Pulmonary Function in Young Adults

Sung-Min SON

Journal of Korean Physical Therapy.2022;34(1):1-5. doi:10.18857/jkpt.2022.34.1.1

Purpose: The impact of prolonged sitting in a cross-legged posture on physiological factors has not been extensively studied. We therefore attempted to evaluate whether prolonged sitting in a cross-legged posture affects pulmonary function in normal young adults. Methods: Twenty-four participants were recruited in this study, and the participants were equally allocated to the normal sitting posture group (NSP group, n = 12) or sitting posture with the cross-legs group (SPCL group, n = 12). The NSP group sat on chairs without crossing their legs for 30 minutes, and the SPCL group sat on the chair with legs crossed (the right knee on the left knee or the left knee on the right knee) for 30 minutes. The pulmonary function of the subjects was evaluated based on forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FVC/FEV1, and peak expiratory flow (PEF) measured using a spirometer. Results: In the intra-group comparison, the SPCL group showed significant differences in FVC and FEV1 before and after sitting (p < 0.05), but no significant differences (p > 0.05) were observed in the NSP group. However, there were no significant differences between the two groups in the pulmonary function parameters measured before and after sitting (p > 0.05). Conclusion Our results confirmed that prolonged sitting in a cross-legged posture could have a negative influence on pulmonary function. Therefore, if a sitting position is maintained for a long time, the correct sitting posture should be maintained to prevent musculoskeletal disorders as well as to maintain normal pulmonary function.

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Review on Physical Therapy for Patients with Vestibular Disorder.

Yong Hyun KWON ; Yu Min KO

Journal of Korean Physical Therapy.2017;29(6):316-323. doi:10.18857/jkpt.2017.29.6.316

Effort to improve balance ability in the field of rehabilitation has been constantly issued and developed up to now. A variety of subcomponent of postural control including function and cognition should be needed in many body systems and be complicatedly linked to each system. In South Korea, although decreased postural dysfunction due to neurological or musculoskeletal disorders has been well documented, we do not have many experience and knowledge of vestibular rehabilitation for maintain and improve balance function. In the United States, vestibular physical therapy is already acknowledged as clinical subspecialty by American Physical Therapy Association. However, there is no curriculum subject related to vestibular rehabilitation in standard education of physical therapy and no specialist who has clinical experience and knowledge of this realm. Therefore, we reviewed general information and basic knowledge of vestibular rehabilitation such as current state of vestibular disorder in South Korea, pathology, major causes of vestibular dysfunction including peripheral vestibular disorders, vestibular neuritis, benign paroxysmal positional vertigo, and central disorder, evaluation of vestibular dysfunction, and treatment for vestibular dysfunction new approaches. We expect that physical therapist in South Korea recognize clinical significance of vestibular exercise and that clinical concern and research will be begun in near future.
Benign Paroxysmal Positional Vertigo ; Cognition ; Curriculum ; Dizziness ; Education ; Humans ; Korea ; Pathology ; Physical Therapists ; Rehabilitation ; Specialization ; United States ; Vestibular Neuronitis

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The Effects of Kinesiotaping Applied onto Erector Spinae and Sacroiliac Joint on Lumbar Flexibility.

Do Yun SHIN ; Ju Young HEO

Journal of Korean Physical Therapy.2017;29(6):307-315. doi:10.18857/jkpt.2017.29.6.307

PURPOSE: The purpose of this study was to investigate the effects of kinesio taping on lumbar flexibility onto erector spinae and sacroiliac joint. METHODS: Sixty healthy adults (male=36, female=24) participated in this study and were randomly assigned to the experimental group that received kinesio taping onto erector spinae and sacroiliac joint (n=30) or the control group that received X-letter placebo taping onto them (n=30). Lumbar flexibility (flexion, extension, lateral flexion, and rotation) was measured using back range-of-motion instrument (BROM) II before and after taping. RESULTS: In the change of lumbar flexibility after taping in the experimental group, there were statistically significant difference in flexion, lateral flexion, and rotation (p < 0.05), but there was no significant difference in extension. There was no significant difference in the change of lumbar flexibility after taping in the control group. CONCLUSION: In conclusion, kinesio taping onto erector spinae and sacroiliac joint improved the joint function. Kinesio taping may reduce the muscle tension and facilitate the circulation of tissue fluid. In light of these results, it is thought that the application of kinesio taping had influence on an increase in lumbar flexibility. Therefore, kinesio taping will be able to be used as the method of the prevention of pain and the treatment in the lumbar region.
Adult ; Humans ; Joints ; Lumbosacral Region ; Methods ; Muscle Tonus ; Pliability* ; Sacroiliac Joint*

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Changes of Gait Variability by the Attention Demanding Task in Elderly Adults.

Sang Seok YEO

Journal of Korean Physical Therapy.2017;29(6):303-306. doi:10.18857/jkpt.2017.29.6.303

PURPOSE: Gait variability is defined as the intrinsic fluctuations which occur during continuous gait cycles. Increased gait variability is closely associated with increased fall risk in older adults. This study investigated the influence of attention-demanding tasks on gait variability in elderly healthy adults. METHODS: We recruited 15 healthy elderly adults in this study. All participants performed two cognitive tasks: a subtraction dual-task (SDT) and working memory dual-task (WMDT) during gait plus one normal gait. Using the LEGSys+ system, we measured the coefficient of variation (CV %=100×[standard deviation/mean]) for participants' stride time, stride length, and stride velocity. RESULTS: SDT gait showed significant increment of stride time variability compared with usual gait (p < 0.05), however, stride length and velocity variability did not difference between SDT gait and usual gait (p>0.05). WMDT gait showed significant increment of stride time and velocity variability compared with usual gait (p < 0.05). In addition, stride time variability during WMDT gait also significantly increased compared with SDT gait (p < 0.05). CONCLUSION: We reported that SDT and WMDT gait can induce the increment of the gait variability in elderly adults. We assume that attention demanding task based on working memory has the most influence on the interference between cognitive and gait function. Understanding the changes during dual task gait in older ages would be helpful for physical intervention strategies and improved risk assessment.
Adult* ; Aged* ; Aging ; Gait* ; Humans ; Memory, Short-Term ; Risk Assessment

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